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Medical-Surgical NRSNG Canada > Inactivity & Immobility > Flashcards

Inactivity & Immobility Flashcards

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USMLE® Step 1 flashcards
1
Q

____ is a person’s ability to move around freely in his/her environment

A

Mobility

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2
Q

___ inability to move around freely

A

Immobility

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3
Q

Is an intervention in which the client is restricted to bed for therapeutic reasons

A

Bed rest

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4
Q

mobility is also related to body changes from aging

A

▫️loss of muscle mass
▫️reduction in muscle strength and function
▫️joint becoming stiffer and less mobile
▫️gait changes affecting balance can significantly compromise the mobility of elder patients

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5
Q

without the stress of weight-bearing activity, bones demineralize.

A

disuse osteoporosis

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6
Q

When muscle fibres are not able to shorten or lengthen

-a permanent shortening (as of muscle) forms, limiting joint mobility

A

Contractures

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7
Q

without movement connective tissue at joint becomes _________ (permanently immobile)

A

ankylosed

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8
Q

As bone demineralize, excess calcium may move to joints, contributing to stiffness and pain.

A

calcium leaves the bones and goes to joint cavity, or goes to blood and kidneys and become CALCULI

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9
Q

A pathological reduction in normal size of muscle fibres after prolonged inactivity from bed rest, trauma, casting, or local nerve damage.

A

Disuse atrophy

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10
Q

What are the intervention to decrease atrophy complications?

A 
▫️body repositioning
▫️weight bearing activities 
▫️deep breathing and coughing exercise 
▫️compression stockings
▫️high protein,calories and fibre diet
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11
Q

Impaired venous return to heart if pooling in extremities

A

Thrombus formation

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12
Q

Decreased mobility (CVS) can lead to ⬆️ in ♥️rate ____

reflex becomes dormant, blood pools in extremities _____

A

tachycardia

orthostatic hypotension

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13
Q

Bed rest can restrict chest movement. Abdominal organs push against the diaphragm (when laying in bed) restricting lung movement - difficult to expand the lungs fully = shallow respiration’s. fluid gets in the lungs causes atelectasis which leads to pneumonia

A

poor oxygen exchange at alveolar level

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14
Q

A stagnation in the normal flow of bodily fluids, such as the blood or urine. Even with voiding in laying position - not emptied completely. ⬆️risk for UTI

A

Urinary stasis

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15
Q

Immobility = excessive amounts of urine calcium (extracts from bones). The calcium salts precipitate out as crystals to form _____

A

Renal Calculi

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16
Q

Immobility effects to GI due to decreased peristalsis and colon motility

A

Constipation

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17
Q

Immobility impedes circulation and diminishes the supply of nutrients to specific area of the skin that causes.

A

Skin breakdown

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18
Q

Nursing intervention for immobility/ inactivity

A

▫️allow patient to perform tasks at his or her own rate
▫️maintain limbs in functional alignment
▫️turn position every 2 hours, or as needed.

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19
Q

Is a chronic, progressive metabolic bone disease.

-low bone mass, structural deterioration of bone tissue, causing fragility and risk of fracture

A

Osteoporosis

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20
Q

Predisposing factors for Osteoporosis:

A
  1. Long-term corticosteroid use (interferes with bone metabolism)
  2. Prolonged immobilization (usage stimulates “remodeling” - absorption and depositing of bone)
  3. Nutritional deficiency
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21
Q

Symptoms of Osteoporosis: Often not until later stages of disease “silent disease”

A

▫️sudden back pains
▫️a decrease in height
▫️kyphosis which is a spine curvature due to bone breakage

22
Q

Osteoporosis diagnostic Evaluation

A

▫️DEXA scan (dual energy X-ray Absorptiometry)
▫️Bone density is the most important predictor of fracture risk

**diagnostics don’t diagnose until 25-40% bone density is lost

23
Q

Modifiable risk factors of osteoporosis (behavioural)

A

▫️inactivity
▫️alcohol abuse
▫️cigarette smoking

24
Q

Pharmacological therapy for osteoporosis

A

▫️Biphosphates (⬇️ rates of bone reabsorption -inhibits osteoclasts activity)
▫️thyroid hormones (slow rate of osteoclasts activity)
▫️selective estrogen-receptor modulators (SERMs)
-estrogen supports bone formation, post menopausal women at risk of OP
▫️Parathyroid hormones
-stimulates bone formation

25
Q

It’s an inflammation of a joint

A

Arthritis

26
Q

It’s a slowly progressing, non-inflammatory disorder of synovial joints.
Cartilage wears down over time. Patients may experience a painful bone-on-bone articulation.
*Cartilage destruction and inadequate repair

A

Osteoarthritis

27
Q

What are the causes of osteoarthritis?

A 
▫️⬇️ of estrogen production (women)
▫️genetics
▫️obesity
▫️exercise 
▫️high joint impact sports (soccer, football)
28
Q

Osteoarthritis symptoms:

A

▫️joint pain (asymmetric) worsening with movement, often relieves with rest (early stages)
▫️joint stiffness (worst in the morning -long rest period)
▫️pain can ⬆️ w changes in barometric pressure
▫️particular mov‘t becomes difficult: sitting, rising from chair
▫️bcoz OA is a non-inflammatory disease, systemic manifestation are not present

29
Q

Osteoarthritis management:
Drug therapy:
Supplement:
Complementary/alternative:

A

▫️NSAIDs
▫️glucosamine and chondroitin sulphate
▫️yoga, massage therapy, acupuncture

30
Q

Three factors collectively predispose a client to the formation of thrombophlebitis (a clot that is loosely attached to an inflamed vein wall)

A

▫️impaired venous return to heart
▫️hypercoagulability of blood
▫️injury to a vessel wall

31
Q

A thrombus is dangerous if it breaks loose becoming an ____

A

▫️Embolus

32
Q

___% of hip fractures are osteoporosis related

A

80%

33
Q

Modifiable risk factor (nutritional)

A

▫️low calcium intake
▫️low vit.D intake
▫️caffeine intake (⬇️ GI calcium absorption)

34
Q

Is an infection of the bone caused by staphylococcus aureus

A

Osteomyelitis

35
Q

Infection of the bone occurs as a result of:

A

▫️extension of soft-tissue infection
▫️direct bone contamination (injury)
▫️bloodborne spread from another site of infection (wound)

36
Q

First line treatment to prevent necrosis in Osteomyelitis

A

▫️aggressive and prolonged IV therapy (think PICC line)

37
Q

What will be the risk for extension of infection in osteomyelitis?

A

▫️bone abscess formation, then cell death

38
Q

Osteoporosis vs Osteoarthritis

A

Osteoporosis: loss of bone mass, ⬆️ing risk for fractures

Osteoarthritis: degeneration of a joint (knees, wrists, fingers, toes, and hips)

39
Q

Is a chronic, systematic autoimmune disease characterized by inflammation of connective tissue in synovial joints
▫️fluctuates between remission and exacerbation

A

Rheumatoid Arthritis

40
Q

Rheumatoid arthritis management:

A 
▫️rest
▫️joint protection 
▫️hot/cold application 
▫️exercise
▫️management/prevention of nodular involvement (internal organs)
41
Q

Primary goals in managing RA:

A

▫️decrease inflammation
▫️manage pain
▫️maintain joint function
▫️prevent or correct joint deformity

42
Q

Inadequate joint movement can result in progressive____ and ___

A

Joint immobility and muscle weakness

43
Q

Over aggressive exercise (OA) can result in _____

A

⬆️ pain, inflammation and joint damage

44
Q

_____ exercise (OA) are usually done daily to keep joints functional

A

gentle ROM

45
Q

It is a systematic inflammatory disease involving _____, _____ , and _____. No specific test or cures.
3 specific presentation such as: ___, ____ and ____

A

▫️joints, connective tissue, and viscera
▫️ systemic, polyarticular and pauciarticular
(same as adults -mostly spleen)

46
Q

Supplement use to manage Osteoporosis?

A

▫️glucosamine and chondroitin sulphate

47
Q

Areas in the body mostly at risk for fracture in young adults due to sports?

A

Femoral shaft fracture

48
Q

How do you position Client post op hip assessment?

A

▫️reduce edema (elevate with pillows)
▫️maintain proper alignment - avoid external rotation (pillow between knees, splint, sandbags)
▫️pain

49
Q

What populations are at greater risk for disuse atrophy?

A

▫️elderly (frail elderly)
▫️physically disabled

🔸bcoz they don’t have the same capacity to rebuild muscle

50
Q

What would be an assessment for immobility/ inactivity?

A

▫️assess skin integrity
▫️assess nutritional needs as they relate to immobility
▫️evaluate need for assistive devices
▫️evaluate the safety of the immediate environment

Medical-Surgical NRSNG Canada (6 decks)

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